Neonatal lupus in consecutive pregnancies


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Background: Neonatal lupus (NL) is usually called a disease of the newborn. The main role in the pathogenesis of NL is attributed to the passive transplacental transfer of maternal anti-Ro/SSA and/or anti-La/SSB autoantibodies. NL is clinically manifested as an isolated skin disease in approximately one half of all the described cases and as an isolated congenital heart block in the other half. Blood, liver, biliary, and other diseases are also described. The most severe presentation of the disease is complete AV block that begins during the second trimester of pregnancy, is irreversible and may require lifelong pacing. Despite the fact that the syndrome is most often detected in children of mothers with Sjogren’s disease, systemic lupus erythematosus (SLE), rheumatoid arthritis, and other rheumatic diseases, the children of asymptomatic mothers can also develop the syndrome at the time of pregnancy. Case report: The authors describe a clinical case of two consecutive pregnancies in a woman who considers herself healthy and have given birth to their children with NL. Her first child has symptoms that can be attributed to the manifestations of NL, such as thrombocytopenia and splenomegaly; the second child has a cardiac conduction lesion and skin eruption. After her second child’s birth, the mother was examined and found to have anti-Ro/SSA and anti-La/SSB, and anti-DNA antibodies, and a decrease in complement components C3 and C4. Moderate SLE (SLEDAI 2K 8) and Sjogren’s syndrome were diagnosed. At the moment, the mother says that her children are healthy and do not receive treatment; planned ECG and 24-hour ECG Holter monitoring have revealed no abnormalities. Different phenotypes of NL and approaches to its therapy are discussed. Conclusion: This case is described to enhance the vigilance of physicians of various prof iles with regard to the possible occult course of rheumatic diseases, while NL in children becomes an indicator of maternal disease.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Tatyana Kirsanova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: a_tatya@mailru
PhD, Senior Researcher of the Department of Transfusiology and Extracorporeal Hemocorrection 117997, Russia, Moscow, Ac. Oparin str., 4

Varvara Yarotskaya

M.V. Lomonosov Moscow State University

Email: varvara.yarotskaya@gmail.com
Faculty of Fundamental Medicine 119991, Russia, Moscow, Lomonosovsky Prospekt, 27-1

Irina Ryumina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: i_ryumina@oparina4.ru., i.ryumina@mail.ru
Dr. Med. Sci., Head of the Department of Pathology of Newborns and Preterm Infants 117997, Russia, Moscow, Ac. Oparin str., 4

Irina Timoshina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: timoshinairina@yandex.ru
Ph.D., Researcher of High Risk Pregnancy Department 117997, Russia, Moscow, Ac. Oparin str., 4

Alyona Potapova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: docpotapovaaa@yandexru
graduate student of High Risk Pregnancy Department 117997, Russia, Moscow, Ac. Oparin str., 4

Natalia Marycheva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: n_marycheva@oparina4.ru
PhD, Dermatologist of Therapeutic Department 117997, Russia, Moscow, Ac. Oparin str., 4

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